For transgender Manning, hormones might play a deciding role in jail

Photo: Reuters

Self-castration, suicide and waves of desperation are byproducts of the denial of sex hormones to inmates yearning to switch genders, advocates say. But outside the walls, debate has been stirred on whether the prison system is the right place to help chemically escort a man to womanhood, or vice versa, and critics question if any taxpayer money should pay for the hormones used to help inmates undergo sex changes.

Thursday's revelation that convicted secret leaker Bradley Manning wants to live as a woman and begin hormone therapy ignited talk about what happens when prison doctors refuse hormones to inmates with gender identity disorder (GID): depression, death wishes, purposely amputated genitalia and, for those already en route to a new gender, the return or disappearance of certain male or female traits — from body hair to muscles to breasts.

The drugs cost about $20 per month for female hormones (estrogen), and about $60 to $80 a month for male hormones (testosterone), she said. Such medical care in prison comes at the taxpayer's expense.

Prior to 2010, federal inmates who entered that system taking sex-change hormones were allowed to maintain those doses, but US corrections officials denied the start of new hormone regimens for existing prisoners. A lawsuit filed by Boston-based attorney Jennifer Levi on behalf of an inmate caused the prison bureau to reverse that stand and treat gender identity disorder even after its diagnosed in prison.

Yet the administering of hormones to transgender inmates remains inconsistent across state prisons: Some do it, some don't, said Levi, director of the Transgender Rights Project at Gay & Lesbian Advocates & Defenders (GLAD).

The Army does not provide hormone therapy to such prisoners. At the very least, this significantly delays Manning's plan to physically morph into "Chelsea" - as he's been sentenced to 35 years in Fort Leavenworth prison.

"The reality is, the underlying medical condition of gender dysphoria is highly stigmatized and widely misunderstood. So people with no expertise, including prison staff, often reject the seriousness of the underlying medical condition just because of bias and discrimination," Levi said to NBC News.

Already battling a deep disconnect with self-identity, then suddenly being removed from the medications meant to alter their genders, some inmates literally attack the issue in the bloodiest ways, lopping off their sex organs.

NBC news claims that about 30 such self-mutilations have been documented in US prisons.

Transgender groups consider denying hormones in cases like Manning's "cruel and unusual punishment" and argue that hormone treatment for gender identity disorder is standard medicine and should be allowed in military prisons as in federal prisons. Manning's request may be the first time this has come up for a military prisoner.

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